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Engaging Employees in the Lean Enterprise Transformation

Employee engagement entails attentiveness to the work at hand (Kahn 1992, Leroy et al. 2013) and characterizes high-performing organizations. VA employees' commitment to its mission contributes to employee engagement. However, engagement also is a factor in improving quality. VA's commitment to lean management includes improving and standardizing processes across operations within medical centers, as well as across medical centers to continuously improve both quality and efficiency. Frontline workers are essential to the learning processes and updating of policies and procedures that are core to the lean enterprise transformation (LET), and they must be engaged to identify and implement improvements (Carroll et al., 2002).

QUERI's Lean Enterprise Transformation Evaluation Initiative is working with the National Veterans Engineering Resource Center (VERC) Office to provide formative and summative evaluation of the transformation. One key strategy of the transformation is attaining employee engagement. The evaluation is being conducted using multiple methods: analysis of process and outcome data, site visits with the initial 10 pilot sites, and administration and evaluation of an employee survey. The survey will measure both employee engagement and middle managers' and senior leaders' actions that contribute to or discourage employee engagement among all staff in each pilot site and an additional 10 comparison sites. That will allow assessment of both the overall engagement in each site, as well as where there are pockets of high or low engagement. It will also allow examination of whether the places within each medical center where LET activities are being conducted have higher levels of engagement. The site visits will provide more extensive information on how engagement is being achieved at each pilot site: what works and what does not.

The evaluation is currently in its first year. Researchers have developed and are testing the new survey instrument, and are conducting the first wave of site visits to the 10 pilot sites. They have been working closely with members of the National VERC Office to ensure that the evaluation includes elements of the transformation strategy, and that it will provide actionable information for our partners.

Martin Charns, DBA and Anita Vashi, MD, MPH
Principal Investigators: Lean Enterprise Transformation Evaluation Initiative